老年持续性腹膜透析患者外周血及腹膜透析流出液辅助性T淋巴细胞亚群分析  

Analysis of T helper cell subsets in peripheral blood and peritoneal effluent fluid in elderly patients on continuous ambulatory peritoneal dialysis

作　　者：谌卫[1] 赖学莉[1] 李娟[1] 吴灏[1] 孙莉静[1] 蔡莉莉[1] 徐海燕[1] 郭志勇[1] 

机构地区：[1]第二军医大学附属长海医院肾内科,上海200433

出　　处：《老年医学与保健》2009年第1期24-26,33,共4页Geriatrics & Health Care

基　　金：上海市自然科学基金（No.07ZR14144）

摘　　要：目的观察老年维持性腹膜透析患者外周血及腹膜透析流出液中辅助性T细胞亚群的分布情况。方法选取长海医院腹膜透析中心60岁及以上稳定透析16例患者为研究对象（老年实验组），同一中心稳定透析且一般营养状态、合并症匹配的60岁以下患者16例为对照（对照组），取外周血及腹膜透析流出液为标本，分离单个核细胞，流式细胞术检测Thelp1、Thelp2、Thelp17及调节性T细胞比例。结果老年实验组外周血中，Th1、Th17细胞比例均降低，分别为（34．2±14．5）％和（1．9±0．6）％，与对照组（38．1±10．7）％，（4．3±2．1）％比较略有降低，但没有统计学意义；Th2、Treg细胞比例咀显升高，分别为（3．2±1．5）％相比于（1．9±1．2）％（P=-0．033），（7．3±2．9）％相比于（4．3±2．1）％（P=0．028），差异均有统计学意义。腹膜透析流出液情况类似，除Th2无统计学意义外，Th1、Th17、Treg细胞亚群在老年组中比例分别为（24．2±11．8）％、（3．2±1．8）％和（8．2±4．3）％，对照组为（30．7±19．2）％、（6．7±2．9）％和（5．9±3．9）％，同比变化明显，P值分别为0．031、0．047和O．022，均有统计学意义。结论老年长期连续性不卧床腹膜透析患者机体细胞免疫功能明显下降、宿主免疫功能紊乱，需要通过更细致的营养、疾病评估以明确是否同年龄因素相关。Objective To observe distribution of T helper cell subsets in peripheral blood and peritoneal effluent fluid in elderly patients on continuous ambulatory peritoneal dialysis （CAPD）. Methods Peripheral blood and peritoneal effluent fluid of 16 patients over 65 years from Changhai Hospital were collected for detection of Th1, Th2, Th17, and regulatory T cell by flow cytometry. According to the nutrition related parameters and pathological conditons, another paired 16 patients on dialysis were selected as control. Results Peripheral Th1 and Th17 subsets of the elderly group were lower than those of the control （34.2±14.5% and 1.9±0.6% vs 38.1 ± 10.7% and 4.3 ±2.1%, respectively）, though the difference was not significantly different, while peripheral Th2 and Treg cells increased significantly （3.2±1.5% vs 1.9±1.2%, P=0.033; 7.3±2.9 % vs 4.3±2.1%, P=0.028）. The case with Th2 subset in peritoneal effluent fluid was similar to that in peripheral blood, except that there were significant changes in Th1, Th17 and Treg cell subsets, 24.2±11.8% , 3.2±1.8% and 8.2±4.3% in the elderly group vs 30.7±19.2, 6.7±2.9% and 5.9±3.9% in the control group （ P = 0.031, 0.047 and 0.022, respectively）. Conclusions Cellular immunofunction decreases significantly in elderly patients on CAPD. Meticulous assessment based on nutritional and pathological conditins should be made to determine whether such decrease is correlated with host defense dysfunction or age.

关 键 词：腹膜透析 持续不卧床 T淋巴细胞 辅助诱导 T淋巴细胞亚群 营养 老年人 

分 类 号：R459.5[医药卫生—治疗学]